Savannah Cardew, MD, FRCP(C), Osteoporosis Program, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, ON.
Successful management of osteoporosis includes nonpharmacologic and pharmacologic strategies, aimed at fracture prevention. First-line therapies include oral bisphosphonates, an intravenous bisphosphonate (zoledronic acid) that is administered once yearly, the selective estrogen receptor modulator raloxifene and parathyroid hormone. Other selective estrogen receptor modulators are being investigated as potential therapies. Strontium ranelate and denosumab each have a unique mechanism of action and may eventually be available in Canada for the management of osteoporosis. In this article the aforementioned therapies will be reviewed with an emphasis on their efficacy in preventing fractures.
Key words: osteoporosis, osteoporotic fractures, zoledronic acid, parathyroid hormone, raloxifene.